Acetabular Labral or Cartilage Tear
The acetabular labrum
The acetabular labrum
- A ring that sits around acetabulum that consist of fibrocartilage and dense connective tissue which encases the femoral head.
- It enhances joint stability, decreases force transmitted to the articular cartilage, and provides proprioceptive feedback.
- Improves the mobility of the hip by providing an elastic alternative to the bony rim. The labrum caries in form and thickness and has a triangular cross section.
- It seems to be avascular but studies have shown that the peripheral part has blood vessels entering penetrating only the outer one-third of it.
- Surrounded by a highly vascularized synovium that is present in the capsular recess.
- Labral tears were thought to be mainly caused by trauma, but research has shown that the tearing rarely exists without bony malformation. In hip dysplasia repeated micro-trauma of the labrum in the relative unstable dysplastic hip joint is thought to cause the tears. This is usually followed by cartilage damage or osteoarthritis. Anterior and superior tears are most common. There does not necessarily need to be a traumatic event for labral tears to occur. They can be classified by their location, etiology and type.
- Insidious pain near groin
- Giving way
- Early diagnosis and treatment is ideal to prevent early onset of osteoarthritis and reduce pain. Arthroscopic detection of chondromalacia is a strong indicator of poor long-term prognosis.
- MRI with contrast
- MR arthrography
- Impingement test
- FABER (Patrick's) test
MR A image
- Arthroscopic surgery
- Peri-Acetabular Osteotomy (POA)
- Conservative treatment consist of rest
- Protected weight bearing
- Anti-inflammatory medication
- Physical therapy, exercise although there is no specific treatment guidelines and is controversial.
- Proper training and conditioning of the commonly used muscles surrounding the hip and the muscles that support them might help reduce the risk of acetabular tears.
- Musculoskeletal education in movement and posture to prevent motions that cause irritation to the hip, such as repetitive and twisting motions of the hip.
- Hip Fracture
- Avascular necrosis
- Acute hip pain with fever malaise, night seats, weigh loss, night pain, intravenous drug abuse, history of cancer and/or compromised immune system may be indicative of tumor, infection, septic arthritis, osteomyelitis or an inflammatory condition